NCLEX-RN MED -SURG HESI LATEST 2024 EXAM/
COMPLETE 200 ACTUAL EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
A client is admitted to the hospital with a diagnosis of severe acute
diverticulitis. Which nursing intervention has the highest priority?
A. Place the client on NPO status.
B. Assess the client's temperature.
C. Obtain a stool specimen.
D. Administer IV fluids. - Correct Answer -A
A client with acute severe diverticulitis is at risk for peritonitis and intestinal
obstruction and should be made NPO (A) to reduce risk of intestinal
rupture. (B, C, and D) are important but are less of a priority than (A), which
is implemented to prevent a severe complication.
Which abnormal laboratory finding indicates that a client with diabetes
needs further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminuria
C. Elevated serum lipid levels
D. Ketonuria - Correct Answer -B
Microalbuminuria (B) is the earliest sign of diabetic nephropathy and
indicates the need for follow-up evaluation. Hyperkalemia, not (A), is
associated with end-stage renal disease caused by diabetic nephropathy.
pg. 1
,(C) may be elevated in end-stage renal disease. (D) may signal the onset
of diabetic ketoacidosis (DKA).
An older client is admitted with a diagnosis of bacterial pneumonia. Which
symptom should the nurse report to the health care provider after
assessing the client?
A. Leukocytosis and febrile
B. Polycythemia and crackles
C. Pharyngitis and sputum production
D. Confusion and tachycardia - Correct Answer - D
The onset of pneumonia in the older client may be signaled by general
deterioration, confusion, increased heart rate, and/or increased respiratory
rate (D). (A, B, and C) are often absent in the older client with bacterial
pneumonia.
Which nursing action is necessary for the client with a flail chest?
A. Withhold prescribed analgesic medications.
B. Percuss the fractured rib area with light taps.
C. Avoid implementing pulmonary suctioning.
D. Encourage coughing and deep breathing. - Correct Answer - D
Treatment of flail chest is focused on preventing atelectasis and related
complications of compromised ventilation by encouraging coughing and
deep breathing (D). This condition is typically diagnosed in clients with
three or more rib fractures, resulting in paradoxic movement of a segment
of the chest wall. (C) should not be avoided because suctioning is
necessary to maintain pulmonary toilet in clients who require mechanical
ventilation. (A) should not be withheld. (B) should not be applied because
the fractures are clearly visible on the chest radiograph.
pg. 2
,When assigning clients on a medical-surgical floor to an RN and a PN, it is
best for the charge nurse to assign which client to the PN?
A.A young adult with bacterial meningitis with recent seizures
B. An older adult client with pneumonia and viral meningitis
C.A female client in isolation with meningococcal meningitis
D.A male client 1 day postoperative after drainage of a brain abscess -
Correct Answer -B
The most stable client is (B). (A, C, and D) are all at high risk for increased
intracranial pressure and require the expertise of the RN for assessment
and management of care.
The nurse includes frequent oral care in the plan of care for a client
scheduled for an esophagogastrostomy for esophageal cancer. This
intervention is included in the client's plan of care to address which nursing
diagnosis?
A. Fluid volume deficit
B. Self-care deficit
C. Risk for infection
D. Impaired nutrition - Correct Answer -C
The primary reason for performing frequent mouth care preoperatively is to
reduce the risk of postoperative infection (C) because these clients may be
regurgitating retained food particles, blood, or pus from the tumor.
Meticulous oral care should be provided several times a day before
surgery. Although oral care will be of benefit to the client who may also be
experiencing (A, B, or D), these problems are not the primary reason for
the provision of frequent oral care.
pg. 3
, The nurse notes that the client's drainage has decreased from 50 to 5
mL/hr 12 hours after chest tube insertion for hemothorax. What is the best
initial action for the nurse to take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing. - Correct Answer – D
The least invasive nursing action should be performed first to determine
why the drainage has diminished (D). (A) is completed after assessing for
any problems causing the decrease in drainage. (B) is no longer
considered standard protocol because the increase in pressure may be
harmful to the client. (C) is an appropriate nursing action after the tube has
been assessed for kinks or dependent loops.
The nurse notes that a client who is scheduled for surgery the next morning
has an elevated blood urea nitrogen (BUN) level. Which condition is most
likely to have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - Correct Answer - B
The blood urea nitrogen (BUN) level indicates the effectiveness of the
kidneys in filtering waste from the blood. Dehydration, which could be
caused by vomiting, would cause an increased the BUN level (B). (A)
would affect serum enzyme levels, not the BUN level. (C) would primarily
affect the blood glucose level; renal failure that could increase the BUN
level would be unlikely in a client newly diagnosed with type 2 diabetes.
Effects of (D) might affect the complete blood count (CBC) but would not
directly increase the BUN level.
pg. 4
COMPLETE 200 ACTUAL EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
A client is admitted to the hospital with a diagnosis of severe acute
diverticulitis. Which nursing intervention has the highest priority?
A. Place the client on NPO status.
B. Assess the client's temperature.
C. Obtain a stool specimen.
D. Administer IV fluids. - Correct Answer -A
A client with acute severe diverticulitis is at risk for peritonitis and intestinal
obstruction and should be made NPO (A) to reduce risk of intestinal
rupture. (B, C, and D) are important but are less of a priority than (A), which
is implemented to prevent a severe complication.
Which abnormal laboratory finding indicates that a client with diabetes
needs further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminuria
C. Elevated serum lipid levels
D. Ketonuria - Correct Answer -B
Microalbuminuria (B) is the earliest sign of diabetic nephropathy and
indicates the need for follow-up evaluation. Hyperkalemia, not (A), is
associated with end-stage renal disease caused by diabetic nephropathy.
pg. 1
,(C) may be elevated in end-stage renal disease. (D) may signal the onset
of diabetic ketoacidosis (DKA).
An older client is admitted with a diagnosis of bacterial pneumonia. Which
symptom should the nurse report to the health care provider after
assessing the client?
A. Leukocytosis and febrile
B. Polycythemia and crackles
C. Pharyngitis and sputum production
D. Confusion and tachycardia - Correct Answer - D
The onset of pneumonia in the older client may be signaled by general
deterioration, confusion, increased heart rate, and/or increased respiratory
rate (D). (A, B, and C) are often absent in the older client with bacterial
pneumonia.
Which nursing action is necessary for the client with a flail chest?
A. Withhold prescribed analgesic medications.
B. Percuss the fractured rib area with light taps.
C. Avoid implementing pulmonary suctioning.
D. Encourage coughing and deep breathing. - Correct Answer - D
Treatment of flail chest is focused on preventing atelectasis and related
complications of compromised ventilation by encouraging coughing and
deep breathing (D). This condition is typically diagnosed in clients with
three or more rib fractures, resulting in paradoxic movement of a segment
of the chest wall. (C) should not be avoided because suctioning is
necessary to maintain pulmonary toilet in clients who require mechanical
ventilation. (A) should not be withheld. (B) should not be applied because
the fractures are clearly visible on the chest radiograph.
pg. 2
,When assigning clients on a medical-surgical floor to an RN and a PN, it is
best for the charge nurse to assign which client to the PN?
A.A young adult with bacterial meningitis with recent seizures
B. An older adult client with pneumonia and viral meningitis
C.A female client in isolation with meningococcal meningitis
D.A male client 1 day postoperative after drainage of a brain abscess -
Correct Answer -B
The most stable client is (B). (A, C, and D) are all at high risk for increased
intracranial pressure and require the expertise of the RN for assessment
and management of care.
The nurse includes frequent oral care in the plan of care for a client
scheduled for an esophagogastrostomy for esophageal cancer. This
intervention is included in the client's plan of care to address which nursing
diagnosis?
A. Fluid volume deficit
B. Self-care deficit
C. Risk for infection
D. Impaired nutrition - Correct Answer -C
The primary reason for performing frequent mouth care preoperatively is to
reduce the risk of postoperative infection (C) because these clients may be
regurgitating retained food particles, blood, or pus from the tumor.
Meticulous oral care should be provided several times a day before
surgery. Although oral care will be of benefit to the client who may also be
experiencing (A, B, or D), these problems are not the primary reason for
the provision of frequent oral care.
pg. 3
, The nurse notes that the client's drainage has decreased from 50 to 5
mL/hr 12 hours after chest tube insertion for hemothorax. What is the best
initial action for the nurse to take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing. - Correct Answer – D
The least invasive nursing action should be performed first to determine
why the drainage has diminished (D). (A) is completed after assessing for
any problems causing the decrease in drainage. (B) is no longer
considered standard protocol because the increase in pressure may be
harmful to the client. (C) is an appropriate nursing action after the tube has
been assessed for kinks or dependent loops.
The nurse notes that a client who is scheduled for surgery the next morning
has an elevated blood urea nitrogen (BUN) level. Which condition is most
likely to have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - Correct Answer - B
The blood urea nitrogen (BUN) level indicates the effectiveness of the
kidneys in filtering waste from the blood. Dehydration, which could be
caused by vomiting, would cause an increased the BUN level (B). (A)
would affect serum enzyme levels, not the BUN level. (C) would primarily
affect the blood glucose level; renal failure that could increase the BUN
level would be unlikely in a client newly diagnosed with type 2 diabetes.
Effects of (D) might affect the complete blood count (CBC) but would not
directly increase the BUN level.
pg. 4
